04-26 386
04-26 386
| Board of Vet. App. | Apr 28, 2017Background
- Veteran served on active duty Oct 1979–Jun 1985; claim for service connection for an acquired psychiatric disorder (including as secondary to service‑connected left adductors myositis/tenosynovitis).
- Initial RO denial (Jun 2003); NOD (Nov 2003); SOC (May 2004); Form 9 (Jul 2004); multiple Board remands for development (2006–2013).
- Board denied claim (Feb 2015); Court vacated and remanded via Joint Motion (Sep 2015) directing further VA opinion addressing etiology/aggravation; AOJ obtained addendum (Sep 2016) and continued denial (SSOC Oct 2016).
- Medical record: in‑service notes (Mar–May 1981) documented situational stress, nervousness and sleep problems; separation (Sep 1985) psychiatric exam normal. First documented post‑service psychiatric treatment not until 2003. Diagnoses over time include depressive disorder, anxiety, bipolar features; claimant asserts onset/continuity since service and secondary relationship to chronic pain from service‑connected adductor condition.
- Multiple VA and private opinions (2012–2016) uniformly found no nexus between current psychiatric disorder and service or the service‑connected adductor condition; September 2016 VA addendum specifically rejected causation and aggravation theories.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the Veteran's current psychiatric disorder is service‑connected (direct/continuity) | Veteran: psychiatric symptoms began in service and continued after discharge (nervousness, insomnia, intrusive recollections) | VA: lack of chronic psychiatric diagnosis in service or within presumptive period; first treatment in 2003 (18 years post‑discharge); medical evidence shows no nexus | Denied — preponderance of evidence against service connection (no continuity/nexus) |
| Whether the psychiatric disorder is secondary to service‑connected left adductors myositis/tenosynovitis (causation) | Veteran: pain and reduced activity from adductor condition produced/worsened depression/anxiety | VA: competent medical opinions found different etiologies, timeframes, and no evidence that the physical condition caused the psychiatric disorder | Denied — medical evidence (Sept 2016 addendum) rejects secondary causation |
| Whether the psychiatric disorder was aggravated by the service‑connected adductor condition | Veteran: physical disability worsened psychiatric condition | VA: addendum opinion concluded no aggravation beyond natural progression; timing/clinical course do not support aggravation | Denied — no competent, probative evidence of aggravation |
| Whether VA complied with VCAA and remand instructions (due process/duty to assist) | Veteran: (implicitly) procedural compliance required, prior remands and JMR necessitated development | VA: provided VCAA notice, multiple remands, obtained records and addendum opinion; substantial compliance with remand | Held — VA satisfied VCAA and substantially complied with remand; hearing legally sufficient |
Key Cases Cited
- Pelegrini v. Principi, 18 Vet. App. 112 (discusses VCAA notice duties)
- Bryant v. Shinseki, 23 Vet. App. 488 (hearing officer duties to explain issues and suggest evidence)
- Stegall v. West, 11 Vet. App. 268 (VA duty to comply with remand instructions)
- Mayfield v. Nicholson, 20 Vet. App. 537 (timing defects in VCAA notice cured by subsequent readjudication)
- Nieves‑Rodriguez v. Peake, 22 Vet. App. 295 (requirements for a medical opinion to be probative)
- Gilbert v. Derwinski, 1 Vet. App. 49 (burden of proof and benefit‑of‑the‑doubt rule)